This stage involves rapid cell division that supplies fresh cells for the upper layers
You want it hit on a glucose-free empty system so it can be fully optimized
Across the ladder, receptor engagement rises about sixfold from the starter dose to the top, and weight loss rises with it
Using K92.1 instead of K92.2 reduces denial risk, improves clean claim rates, and demonstrates compliance with payer requirements for specificity
vitamin D intake ~20% of recommendations Lean mass risk: protein + calcium insufficiency may contribute, alongside other drivers B-vitamins: thiamine and cobalamin deficits appear to increase over time Clinical takeaway (my approach): GLP-1s dont cause malnutrition in everyone but they can unmask risk in the wrong context (older adults, low-protein diets, restrictive eating patterns, prolonged nausea/vomiting, rapid weight loss, post-bariatric patients)
Apr 2025;34(2):232-239